Most claims finish with money moving — an excess taken from the policyholder, a settlement paid out. Your agents handle both on the same call, with DTMF-masked card capture so no card data touches your contact centre, built on Paytia Secureflow.
Most claims management software is built for one vertical, and the payment step — the bit where the excess comes in and the pay-out goes out — is usually tacked on as an afterthought. Your team ends up running the workflow in one tool and fielding card payments in another, which is where the cost, the errors, and the PCI scope all live.
Expensive Customisation
You're paying twice -- once for software that doesn't fit, then again to make it work. Bolt-on features rarely sit properly alongside the core system, so you end up with maintenance headaches that never go away.
Extended Time to Market
While you're waiting months for customisations, your competitors are already settling claims. Every week of delay costs money in manual handling, errors, and lost customer confidence.
Process Compromises
You end up changing how your business works just to keep the software happy. Your approval workflows, compliance requirements, and customer interactions get squeezed into templates that weren't built with you in mind.
Paytia is different
You tell us how your claims team actually works — from first call to settlement — and we build the claims payment software around that. DTMF-masked phone capture, PCI DSS Level 1 cover, no card data touching your contact centre.
Designed to fit -- not forced to fit
Instead of bending your process around a generic tool, we build the claims automation software around how your team actually handles a call. Complex approvals, real-time sync with legacy systems, sub-company permissions — all built in, all wrapped around a secure phone-payment step that sits wherever your flow needs it.
Custom capture forms aligned with your claims processes
Branded interfaces that support your team and customers
API services that integrate directly with your CRM and financial systems
Custom admin controls with your permissions and dashboards
Automated payment settlement with full audit trails
AI-powered routing and fraud detection
Faster go-live
We stand up the phone-payment capture and the core claims workflow first, so your team's taking excesses and authorising pay-outs on a call within weeks. The rest of the features follow on a rolling basis.
50-70%
Faster time to market
What we deliver
Here's what you get when we build your claims payment software — every piece shaped around your team's workflow, with secure phone capture at the middle of it.
Smart Data Collection
Captures what you need and handles compliance in the background. The system knows which data needs extra protection -- PII, financial data, and medical information all get classified and encrypted properly. Works with any currency.
Your Brand, Your Interface
Everything looks like part of your business. Your team sees interfaces that make sense for their workflows, and your customers see your brand from start to finish. No generic third-party logos getting in the way.
Plays Well with Others
Connects to your CRM, accounting software, ERP, and legacy databases. Everything talks to everything else through REST APIs, webhooks, and custom integration layers -- we build whatever's needed to make the pieces fit.
You're in Control
Set the system up exactly how you want -- who can access what, which dashboards people see, approval hierarchies, day-to-day operations. Role-based permissions handle complex org structures without a fuss.
Instant Updates
When something changes in your claims system, other systems know about it straight away. No delays, no batch processing -- everything stays in sync through real-time event notifications and webhooks.
AI Chat & Voice Bots
Automate routine claim intake and payment capture with conversational AI. Bots handle initial data collection, status enquiries, and simple resolutions, so your team can focus on the complicated cases that actually need a human.
Inbound Payment Capture
Collect excesses on the phone call, with DTMF masking hiding the card digits from your agent and your call recording. Real-time validation catches bad cards before you burn the call, and the data is tokenised the moment the customer keys it in.
Automated Outbound Payments
Schedule automated claims payment out to the policyholder — single pay-outs on the same call, or batched runs on your usual cycle. Full reconciliation tracking, same place.
Document Management
Secure upload, storage, and retrieval for supporting docs. Virus scanning, format validation, and automated classification mean files are handled properly and easy to find when you need them.
The Paytia methodology
Build the payment experience your business actually needs
Claims management platform architecture
Full workflow system with multi-company support, granular security, and integrated channels
External Customer
Customised electronic capture forms
Customer satisfaction surveys
Secure customer answer and banking data collection
Platform Channels
Inbound and outbound telephony channels
Inbound and outbound social media channels
Email, SMS, and web portal channels
Customised Workflow System
Primary Platform Users
WORK FLOW QUEUE
SUB-COMPANY Platform Users
WORK FLOW QUEUES
SUB-COMPANY Platform Users
WORK FLOW QUEUES
Multi-company work task exchange
Primary Agent
Escalated Approval Agent
SUB-Admin User
Primary Admin User
Data classification and security
Reporting and KPI monitoring
Granular security structure
Built around your process, not ours
We don't bend your process around our product — we build the product around your process. Approval flows, data sync, and the secure phone-payment step all sit wherever they need to in your call handling.
Faster go-live with phased delivery
Milestone-based rollout -- essential services go first
Secure, scalable, compliant
PCI DSS compliant architecture with security baked in
Future-proof with AI integration
AI-driven workflows and automation built into the platform
Pinnacle Group — how it works in practice
Pinnacle needed multi-stage approval workflows, automated payment settlement, and direct integration into their legacy financial systems — none of which their previous solution could handle without expensive workarounds.
We built them custom automated claims settlement software on Secureflow. 85% of their workflow is now automated, admin time dropped by 60%, and their team takes excesses and authorises pay-outs round the clock without anyone babysitting it.
85%
Faster processing
60%
Admin reduction
24/7
Automated
Pinnacle Group success story
Pinnacle needed claims management software that could handle their approval workflows, automate their payments, and talk directly to the systems they already had — without dragging card data through their contact centre.
Their previous setup meant manual graft, no multi-tenant support, and nothing that could connect to their legacy financial systems — let alone take a phone payment inside a claim workflow. We built them a custom claims platform on Secureflow that automated 85% of their workflow, plugged into the kit they already had, and moved every claims payment onto a secure phone call.
Custom Workflow Engine
Multi-stage approval processes with automated routing, notifications, and escalation rules
Automated Payment Processing
Secure outbound payments with real-time validation, audit trails, and reconciliation
Legacy System Integration
Direct API integration with existing claims, financial, and CRM systems
Multi-Tenant Architecture
Sub-company access controls with dedicated workflow queues and reporting
“Paytia delivered exactly what we envisioned -- a complete claims management ecosystem that integrates perfectly with our operations. No compromises, just results.”
Key results delivered
85%
Faster processing
100%
Audit compliance
60%
Admin reduction
24/7
Automated processing
Custom features delivered:
Multi-tenant approval workflows with sub-company permissions
Real-time payment validation and fraud screening
Automated documentation generation and archival
Custom reporting dashboards with role-based access
Mobile-responsive interfaces for field workers
API integration with legacy CRM and billing systems
Advanced claims management capabilities
Built your way, delivered fast. No compromises — just secure phone-payment capture wrapped in a claims workflow shaped around how your team actually handles a call.
AI Chat & Voice Bots
Automate tasks and capture payments with conversational AI using natural language processing. Bots handle initial claim intake, status enquiries, and routine payment collection -- the repetitive work your team shouldn't be doing.
Custom Channels
Take payments and claim submissions through social media, SMS, live chat, email, or whichever channel your customers actually use. Everything feeds into one view so nothing gets missed.
Real-Time Analytics
Dashboards showing claims in flight, payment status, agent performance, and where the bottlenecks are -- so you can make calls based on what's actually happening, not last month's report.
How claims processing software works
Automated claims settlement software handles the whole workflow — intake, approval, and the phone call where the customer pays the excess or the agent authorises the pay-out. Manual handling drops by 75%, accuracy climbs to 95%, and every payment runs through PCI DSS Level 1 infrastructure.
1
Claim Intake
Capture through phone, web, email, or API. Automated validation, duplicate detection, and form routing based on claim type.
2
Workflow Routing
Routes by claim type, amount, complexity, and your business rules. Auto-assigns to the right reviewer, with escalation you configure.
3
Review & Approval
Multi-stage approval workflows with escalation rules, SLA tracking, document management, and audit trails on everything.
4
Payment & Settlement
PCI-compliant phone payments, secure settlement on the same call, automatic reconciliation, reporting, and integration back into your financial systems.
Automated claims processing benefits
Processing Time Reduction
Cut manual handling from 40 hours a week down to 10 — a 75% drop for businesses running 1,000+ claims a month. Automated routing, approvals, and phone-payment capture mean the excess lands on the same call, not in next week's invoice batch.
Accuracy Improvement
Automated claims automation software hits 95% accuracy versus 70% manual. Fewer reworks, fewer errors, and — because the card digits are captured by DTMF masking on the call — fewer compliance headaches waiting in your recordings.
Cost Savings
Typically GBP 50,000-200,000 saved a year through lower labour costs, fewer errors, compliance cost avoidance, and better customer retention. Most customers see ROI within 3-6 months.
Compliance Built-In
PCI DSS Level 1 for payments, HIPAA for healthcare, GDPR for data protection -- all baked into the workflow. Audit trails are produced automatically, so there's nothing to chase later.
Benefits of automated claims processing
Automated claims processing cuts manual handling, speeds up settlements, and gives your team time back for the cases that actually need a human.
75%
Time reduction
Reduces processing time from 40 hours/week to 10 hours/week for 1,000+ claims monthly.
30 hours/week saved for higher-value work
95%
Accuracy
Automated validation and routing achieve 95% accuracy vs 70% with manual processing.
25% improvement vs manual
GBP 50k-200k
Annual savings
Savings from reduced labour, error reduction, compliance cost avoidance, and improved retention.
GBP 74k-94k typical annual savings
Insurance claims processing
Insurance claims are among the trickiest workflows out there — and they almost always end on a payment. We handle the full lifecycle: first notification of loss, approval, and the phone call where the settlement payment moves. No paper cheques, no separate card terminal.
Property & Casualty Claims
Handle property damage, motor, liability, and casualty claims with workflows that match your own underwriting rules and approval hierarchies -- not a generic template someone else designed.
First notification of loss capture and triage
Adjuster assignment and field inspection workflows
Multi-level approval based on claim value
Automated settlement calculation with phone-based pay-out
Subrogation tracking and recovery management
Health & Life Insurance Claims
Handle healthcare claims, life insurance payouts, and disability claims with HIPAA-compliant data handling and automated provider verification.
Medical billing verification and coding validation
Pre-authorisation workflow automation
Provider network verification and fee schedule matching
Explanation of benefits generation
Patient responsibility calculation and collection
Industry applications
Claims management software isn't just for insurers. We run it across healthcare, utilities, financial services, and retail — anywhere a claim ends on a phone payment or pay-out.
Insurance Claims
Property, auto, health, and life insurance claims with adjuster and provider integration.
Property damage claims
Auto accident claims
Health insurance billing
Life insurance payouts
Healthcare Claims
Medical billing, insurance verification, and pre-authorisation with HIPAA compliance.
Medical billing to insurers
Insurance verification
Pre-authorisation workflows
Patient reimbursement
Financial Services
Payment disputes, chargebacks, and fraud claims with PCI DSS compliance.
Payment dispute resolution
Chargeback processing
Fraud claim investigation
Account error corrections
Utilities Claims
Service claims, billing disputes, and damage claims with utility system integration.
Service interruption claims
Billing dispute resolution
Property damage claims
Overpayment refunds
Retail Claims
Warranty claims, returns, and refunds with e-commerce and inventory integration.
Product warranty claims
Return authorisation
Refund processing
Shipping damage claims
Custom Workflows
Paytia Secureflow enables custom claims processing for any industry or unique requirement.
Every payment captured during a claim is validated in real time, so fraud and errors get caught before settlement, not after.
BIN (Bank Identification Number) verification checks
LUHN algorithm validation for card number integrity
Card type and brand blocking capabilities
Velocity checks to detect unusual patterns
Security protocols
Sensitive claims data and payment information is protected by multiple security layers across the whole workflow.
3DS2 identity verification for e-commerce transactions
Content Security Protection against man-in-the-middle attacks
Full transaction reporting and audit trails
Encryption using TLS 1.2+ and AES-256
Claims workflow automation
Handle every stage of your claims process — from first call through to the secure phone payment or pay-out that closes it. Powered by Paytia Secureflow.
Intake and initial assessment
Custom forms capture claim details, supporting documentation, and initial payment information. Real-time validation keeps the data clean and compliance tight right from the first click.
Forms adapt based on claim type, jurisdiction, and your business rules. That cuts incomplete submissions by 85% and means agents and customers give you the information you actually need, first time.
Multi-step form validation with global currency support
Automated duplicate claim detection and flagging
Secure document upload with virus scanning
AI-assisted data extraction from uploaded documents
Smart Data Collection
Forms adapt based on claim type, jurisdiction, and business rules to collect only relevant information.
85%
Reduction in incomplete submissions
Secure Payment Processing
Encrypted payment capture with real-time fraud detection and compliance validation. All card data is tokenised.
100%
PCI DSS Level 1 compliance
Payment and settlement
Secure phone payments with direct API integration into your existing financial systems. Works for immediate pay-outs on the same call or scheduled settlement runs — audit trail is there either way.
Settlement payments run through PCI DSS Level 1 infrastructure. Card data is tokenised at capture and never stored in your environment, which takes a big chunk out of your compliance burden without giving up any of the audit trail.
Real-time payment validation and processing
Automated reconciliation with existing accounting systems
Full transaction reporting and analytics
Support for multiple payment methods and currencies
Intelligent data classification and compliance
Sensitive data gets identified and classified automatically, so regulatory compliance and data protection aren't afterthoughts. The platform tags PII, MII, and financial data on the fly and applies the right encryption and access controls to each.
PII data tagging
Personally Identifiable Information is spotted and tagged automatically, so regulatory compliance is handled from the start.
Name and address information
Social security and ID numbers
Financial account information
Communication data (email, phone)
MII data tagging
Medical Information Identification gets specialist handling -- the sort of thing HIPAA expects, built into the platform rather than bolted on.
Medical record numbers and identifiers
Health insurance information
Medical diagnosis and treatment codes
Provider and facility identifiers
Automated compliance
Data protection policies are enforced in real time, with encryption and access controls applied automatically rather than left to chance.
Automatic field-level encryption
Role-based access controls
Audit trail generation
Data retention policy enforcement
Frequently asked questions
What is claims processing software?
Claims processing software automates the intake, routing, handling, and settlement of insurance, healthcare, and financial claims with custom workflows and secure payment integration. The bit that usually hurts is the payment step — we build it as a DTMF-masked phone capture on the same call, so your agents never hear the card digits. Our Secureflow platform handles the lot, and because card data is tokenised at capture, it never lands in your systems.
How does automated claims processing work?
Automation routes claims through approval stages, checks the information, processes payments, and produces reports without anyone having to chase things manually. We capture claims through phone, web, email, or API, run them through workflows with your own approval rules, and hand off to payment systems for settlement.
Is claims processing software secure?
Yes. We're PCI DSS Level 1, with encryption in transit and at rest, isolated data storage, and full audit trails. Because payment data is kept separate from your business systems, most customers drop from SAQ D (329 requirements) to SAQ A (22 requirements). PII, MII, and financial data each get handled according to their classification.
What industries use claims processing software?
Insurance, healthcare, financial services, utilities, retail -- anywhere claims or disputes need handling. That covers insurance claims, medical billing, warranty claims, customer service resolutions, property damage claims, and chargebacks.
How long does implementation take?
Simple claims workflows are usually live in 1-2 weeks. Bigger systems with multiple integrations run 4-8 weeks. We work in weekly release cycles and build the features you need first, so you're seeing results early rather than waiting months for a big-bang go-live.
Can it integrate with our existing systems?
Yes. We connect to CRM, ERP, billing, and financial systems through APIs, webhooks, and custom integrations. You don't need to replace your existing platforms — we work alongside them, with real-time sync to keep claims, payments, and customer records aligned.
What is the difference between claims processing and claims management?
Claims processing is the nuts and bolts -- intake, routing, approval, settlement. Claims management is the wider picture: analytics, reporting, performance monitoring, and tuning the process over time. We cover both in one platform.
How does claims software handle payment compliance?
Every payment goes through PCI DSS Level 1 infrastructure. Card data is tokenised at capture and never stored in your environment. Because the digits are captured by DTMF masking during the phone call, nothing PCI-relevant sits in your call recordings or agent screens. We also cover GDPR for data protection, HIPAA for healthcare claims, and produce the audit trails regulators want to see.
Can claims processing software reduce fraud?
Yes. We've got duplicate claim detection, pattern analysis, velocity checks, and anomaly spotting built in. AI can flag anything suspicious for manual review, and because sensitive data is locked down, there's less for anyone to get at in the first place.
What reporting is available for claims management?
Processing times, approval rates, settlement tracking, agent performance, customer satisfaction, financial reconciliation -- it's all there. You can build custom dashboards per role, and export to whatever analytics tools you already use.
